| Long Term Care Associates Inc | |
|
3619 S Delaware Ave Independence MO 64055-3188 | |
| (816) 803-5173 | |
| (816) 461-2367 |
| Full Name | Long Term Care Associates Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3619 S Delaware Ave, Independence, Missouri |
| Authorized Official Name and Position | Michael H Nielson (OWNER) |
| Authorized Official Contact | 8168035173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Term Care Associates Inc Po Box 752 Concordia MO 64020-0752 Ph: (660) 463-1365 | Long Term Care Associates Inc 3619 S Delaware Ave Independence MO 64055-3188 Ph: (816) 803-5173 |
| NPI Number | 1982616710 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 07/25/2012 |
| Medicare PECOS PAC ID | 5799889150 |
|---|---|
| Medicare Enrollment ID | O20070326000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982616710 | NPI | - | NPPES |
| 505740902 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael H Nielson |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1710944764 PECOS PAC ID: 6305940032 Enrollment ID: I20080319000637 |
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